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Effects of marital self-disclosure on marital relationship and psychological outcome for cancer patients: a systematic review

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Abstract

Purpose

Literature on marital self-disclosure interventions for cancer patients lacks consistency in methodology and content. Moreover, the impact of such interventions on physical and psychological health, marital relationships, and self-disclosure ability is controversial. This review aims to systematically analyze the studies of marital self-disclosure intervention, synthesize the structure and topics of marital self-disclosure, and summarize and evaluate its effects on improving physical and psychological outcomes and marital relationships in cancer patients and their spouses.

Method

This systematic review used the preferred reporting items of Systematic Reviews and Meta-Analyses (PRISMA). We conducted a systematic review of randomized controlled and quasi-experimental studies published from the establishment of the database to October 2022. Marital self-disclosure interventions were conducted with both cancer patients and their spouses. Studies published in a language other than English or Chinese, and studies below a quality grade of C were excluded. Data were extracted through a standardized data collection form, and two reviewers independently extracted and evaluated the data. The quality of the included studies was assessed using the Cochrane Handbook of Systematic Reviews of Interventions, and a third reviewer adjudicated in case of disagreement. The data were synthesized by vote counting based on direction of effect according to the Synthesis Without Meta-analysis (SWiM) reporting guideline.

Results

Thirteen studies were included in the review. Based on quality evaluation, three studies were categorized as grade A (good), and ten studies were grade B (moderate). Seven studies reported moderate rates of participant refusal and attrition. The structure and topics of marital self-disclosure varied across different studies. The five studies had various prespecified disclosure topics, such as fear of cancer recurrence, benefit finding, and emotional distress. The overall results suggest that marital self-disclosure interventions can improve physical and psychological health, enhance marital relationships, and increase self-disclosure ability.

Conclusion

The limited number of studies, small sample sizes, diverse intervention strategies, and methodological heterogeneity weakened the evidence base for the effectiveness of marital self-disclosure interventions. Therefore, further high-quality randomized controlled trials (RCTs) are recommended to confirm the effectiveness of such interventions. These studies should also evaluate the interventions’ long-term impact, analyze optional topics and methods, identify key features, and explore the development of the best intervention program.

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Data availability

All data supporting the findings of this systematic review can be found in the paper and its supplementary information.

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Author information

Authors and Affiliations

  1. Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia

    Ye Zhou, Chong Chin Che & Mei Chan Chong

  2. Nursing Department, Jingjiang People’s Hospital, Taizhou City, Jiangsu Province, China

    Haiyan Zhao & Yin Lu

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  1. Ye Zhou
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  2. Chong Chin Che
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  3. Mei Chan Chong
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  4. Haiyan Zhao
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  5. Yin Lu
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Contributions

Ye Zhou, Yin Lu, Haiyan Zhao: data extraction and literature quality appraisal. Ye Zhou: data analysis, writing—original draft preparation. Chong Chin Che, Mei Chan Chong: supervision, conceptualization, writing—reviewing and editing.

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Correspondence to Chong Chin Che.

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Zhou, Y., Che, C.C., Chong, M.C. et al. Effects of marital self-disclosure on marital relationship and psychological outcome for cancer patients: a systematic review. Support Care Cancer 31, 361 (2023). https://doi.org/10.1007/s00520-023-07826-z

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